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HomeMy WebLinkAbout17623-zFORM N0. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCE)PANCY No 220117 Date JULY 29, 1991 THIS CERTIFIES that the building ADDITION Location of Property 2005 REEVE AVE. MATTITUCK House No. Street Hamlet County Tax Map No. 1000 Section I00 Block 03 Lot 09 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Perm~.t heretofore filed in this office dated NOV. 16, 1988 Pursuant to which Building Permit No. 176232 dated NOV. 18, 1988 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is 2ND FLOOR ADDITION TO ONE FAHILY DWELLING. The certificate is issued to PAULETTA AND GREGORY GIIRFEII3 (owners) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N(A CERTIFICATE N0. H023174 JULY 12 1991 PLUMBERS CERTIFICATION DATED GREGORY GURFEIN JULY 24 1991 ui ding Inspector Rev. 1/81 roans xo. s TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT CfHiS PERMIT MU5T BE KEPT ON THE PREMISES UN71L FULL COMPLETION OF THE WORK AUTHORIZED) N~ Ci17b23 Z Dote ...Na.-1~-,~:c~<.....L.~..........., 19.~.~ Permission ~s hereby granted to ... ~ ............ C?....k~~-r~ ... ........ .. ................................ ...... ~ -~- ta.~r.!?`^::Q1.,JI:~~S.~'..g.,~.Q.s~' CL ~.it1.d......,~?'~'~.....~...4r~'.. j ............. .. V i e ...........~,......~-:.....~.... ... ..` ate.. . .... ..................................... ct premises located of .. . ~ ~ Sl,........,}...R~SJ.-Q...... ~..H:+i.:....~.RI~Y~.~rt:l..~........... Counh~ Tax Map No 1000 Section ... ~ ~v. Block ... ~...~~...... Lat No ~...J.. .. pursuant to opphcation dated ..~ d'4~:-?'!^~~~h, ...1 ~... p ... 19.0. ., and approved by the 6uddmg ln{~s(p~ectar Fee $. ~ A ..j :. ~ ~ ................................ .... ....... Building Inspector Rev 6!30!80 fj7 ~ !~ '1- ~ ~'~ ~ 601/ form No. 6 TOSJN OP SOUTItOLD SUILDINC DEPA12Tf1LNT TOWid 1L1LL 765-1802 ^ 1 ~ IS ~. 2 61991 , ~ ,~ BLtJCa ULi •.. TOWN OF ~n~ i' ~, APPLICATION POR CLRTIPIChTL Or OCCU G1NCY ~. This application must be filled in by typewriter OF, ynlc and submitted to the buildin,^, inspector w7_th the Following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Fin a1 Approval from Health Dept. of water supply and sewera;e-disposal(S-O form). 3. Approval of electrical installation from Board of Pire Underwriters. 4. Sworn statement from plumber certifying that the solder used in system contains less than 2J10 of 17< lead. ~ 5. Commercial building, industra.al building, multiple residences and similar buildings and installations, a certificate of Code C~.mpl~.ance from archL_ect or engineer responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. .. For existing buildings (prior to April 9, 1957) non-conform~.ng uses, or buildings ane "pre-existing" land uses: 1. Accurate survey of property show in; all property lines, streets, building aad unusual natural or topographic features. 2. A properly completed application and a consent [o inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00, AddiCions to accessory building $25.00. Busiresses $SO 00. 2. Certificate oC Occupancy on Pce-existing Building - $100.00 3. Copy of Certificate of Occupancy - $5.00 over 5 years - $10.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential /$15.`001, Commercial $15.00 Date ....~c13:-~JGtJ ............................ ew Construction y Old Or Prc~ existing Building.. J/ .. ... .. ccation of Property.... r.... ..;ty ........ ......... lsouse No. Str/;eet ~^ Hamlet twer or Owners of Property......~151~.~`~T~.!~~..~!~.~14f.~~..12J~F1111:~ . .................... unty Tax A1ap No 1000, Scction.....R Q~~.....B1uc1c.....Q ~........Lot....~.~ ............... bdivision .............. ......................riled tap............Lot...................... emit Mo..Ql.l~.'3;'3... Datc Of Permit.. ~,('.~1 ~11~~. ..Applic:.tnt ..~~:~Gf:~^:!GY~1.°~'.1!~y....... ~lth Dept. Approval ..........................Underwriters Approval......................... Inning Beard Approval ........................ ;uest for: Temporary Certificate........... Final Certu.ate........... Submitted: $ . .......................... .i. - .......... .A PPLIC •.`T• ..................... -1dLD ILSIECTiu;J ~ ~DATE ~ i;OMGEEN7~ ~ . ~ /1 P ~ , ~' ~.. ..dl _ ___ _ ,/ FOUi1DATI0N ( 16~t ) - - - - _ - - . FOUNDATIOIJ (2nd) f 2 ~_ . , ROUGH FRAME & LM P LUMBING d ~ -, , ~~ i INSULATION PER N. X. STATE ENERG „ S~/~o Y ~ ~ 4 -~ i ~ . FIidAL 4 ~ ADDITIOfJAL COMME1dTS: ~ c h I C C C C u.nw~M'....w+.nr• t1'ilwxyr~wMAYe~suum.aww:w ~~nuukY. ~ulNwfseu3eA ' `-_ __ - 0 N q ~` ¢ H m Q 3 1 6 "S YW~Q Yz~ m ~ N ~ _ 32 ~ w £wKm t S E ° y c 3 ~ ~ ~ i ~yoZ3 y4 _ t m I ZVw~< !'* S ~ W J OvOQf d ~ C W S ; N ~S~ ~ 2 ~m~u mY ~i. I. O ~ N Q ~ ANN ~ I-' ~ nV ' O r r 1 ~ ~ u 6p x u{ ~ ~ k a ~ i s ' 3i SOi arc y . ; a ~ o a s W ~ $ °~ ~ ~ m i ~ 'X i V Y ; F O r-~ ,k Y n k ~ ~ ~ x g n' Kx o v r- u z ~ ~ > i , ~ O ry ~ ~ C W } C o F pY 8 ~ V __ ~ r. ~y ~ ~ y. 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Swo//r~~n~~{{ o befor^ ^ t//k:is ~(pr~day of ~~(N 19 ~~ . Votary Public, ~~~County ~~ ( lump is si nature) ~~~~ ~~~ Notary Public ~Y ~~Na~~48 I~Lrk Oe~niquonExpini~` (Z-- D.ambrb~11.., ~7~0~3 765-1802 BUILDING DEPT. 1 NSPECTION [ ]FOUNDATION 1ST ( ) ROUGH PLBG. [ ] FOUNDATION 2ND NSULATION [ ]FRAMING ~ INAL REMARKS: ~f q DATE L / INSPECTOR ~~~ z~ 765-1802 BUILDING DEPT. INSPECTION [ ]FOUNDATION i5T (1~]~~UGH PLBG. [ ) FOUNDATION 2ND [ ) INSULATION [ ]FRAMING [ ]FINAL DATE ~ INSPECTOR REMARKS: ~'~/~~ (~.G rss-isos BUILDING DEPT. INSPECTION [ ] FOU TION 15T [ ] ROUGH PLBG. ( FOUNDATION 2ND [ ]INSULATION [ ]FRAMING [ ]FINAL REMARKS: ~' ~ DATE ~. ~7~ a3 765-1802 v BUILDING DEPT. INSPECTION [ ]FOUNDATION 1ST ~ ] ROUGH PLBG. [ ] FOUNDATION 2ND iNSUi.AT10N [ ]FRAMING [ ]FINAL REMARKS: ~~a~ C~ DATE ~~~ INSPECTOR ~ ~~z ~ 765-1802 BUILDING DEPT. INSPECTfON [ ]FOUNDATION 1ST ( OUCH PLBG. [) FOUNDATION 2ND [ )INSULATION [ ]FRAMING [ ]FINAL REMARKS: f .~'°" %# °~- ~~,. DATE ~ ~~ ~ INSPECTOR ~ ^'r"`~ ~~ ~3 765-1802 BUILDING DEPT. INSPECTION [FOUNDATION 1ST ( ] ROUGH PLBG. [ ~ FOUNDATION 2ND [ ~ INSULATION DATE ~ ~ ~O~ ~~ INSPECTOR ~~` ~/ [ ]FRAMING [ ]FINAL l 7~ L3 r6s-iS02 BUILDING DEPT. INSPECTIC?N [FOUNDATION 1ST ( } ROUGH PLBG. ( ] FOUNDATION 2ND ( ]INSULATION [ ]FRAMING ( ]FINAL DATE ~ ~` 6 / INSPECTOR ~~~ REMARKS: ~,~ r4`~L I f i r { •k ~ ~- . ..~< 4 ,~ ~~ _.m9 . "E HpRg~RViEW "70`1120 ,~ z [ .~:~..~ l _ A ?, ~ N ~. - a m - ~ o 0 2 m v E o - [n ~ ~ o ro [n ~ a ~ , .o ~~~ _ m ~\ 1 \` 1 ,, -~..5 pVEN~~ - zp5 00 ~ ~ ~ W ~ .5 ~,~ .. [ , •m ~= _ ~~ [ [ , ~6 . 36.353 s t qre° _• 5 7; 36 30 A v ~ a `y ~. ;~'~ .,f 'Inlet "- SUh4nrsi0n - 6249 G~Iz No 4 Lal ri1/e No 779 - 475 - S + +~, m m ~ ,. n 1 m ~ z m ~ - - - ~~ ~ _- 1 I SURVEY FOR '°OlK COUNTY CERAR(MEtT OF HE. aH EERYIr FS CLA/RE UL/ANO ^ AT NdTTITVCX GATE DFC 19, 38D FOR APPppygE OF CONSTZLCSIOV C r TOWN OF j0C/TNOLO SC>[E /". SOS - HS RE. ~ O SUFFOLK COUNTY, NEW YOPK NO BS OSB __-_- no +ue+, -_-___ -_ Gcd94RrEF0 ro _ __ 1 swnox • v REER_ESS gRSrP<Cr C04R R`7 iii iwci. o+... ea e - ---- • nA> m~[ eu+vn + ~ uaa.n rx[ v GLd/RE lL GYO um ~`n[ . E SAM ?EPa RI Mffl[ Jnr>F:A aPefl,.t rJ 'LStnpCr u• ~"`.~,. a + ~r L. era 5 Yh.V 9 n[ ,q` •• a~ ~ ` we ~n. ~2 w. _L i r ~ µ - '•ew .~o m rv[ ++ +[es a. ~:c ~i+ei,n _ . +e,[ ~ ~o a.n. na nrn. co . n. .,~• ~ . c +• n rzo .,e .e. n.[ y ^' [c n r•[..x ., ., , %x. T..:o[•.n x[.r ~ ~•~ ~..ai u,v.n .[, ...... ,~.[nn ~,[, r _ _ _ _ ~ YOU~lG $ YQLJ~dG "QOM'°F";° ^.t~^'E .c'rF _I.1. j • v i.wEVr .C~ _ -r..,. . ~.r II I sl lFV « r^.uN4 P4'GE , r,ra, y,y an ~ -arv0 $bPO E':4 fl r-+ . Ex . .ti[ ti r.e - ,... ~ r ~4]1 i9l I u[Mr a` BOARD OF HEALTH ...... 3 SETS OF PLANS ....... FORM NO 1 SURVEY TOWN OFSOUTHOLD CHECK ••-••••••- BUILDING DEPARTMENT SEPTIC FORM .............: TOWN HALL NOTIFY ~ ifJ~. SOUTHOLD, N Y 11971 CALL - -~~~- •`:'~-,~- ~~/7 TEL 7651802 ,` MAIL T0. Examined /!.! a'~''i!'1~ .~ ~ , 19~ ~ -- rSia°'.,t Wes:.! ~ ~ Pennrt No +~ ~ ~.3 "~' ~ ` ' ` ` ' . Approved ..., 1 E.'P . , ..... ...... ~'~ 1 6 f ~ ~ Disapproved a/c .. ~ nVi~ ~ ~ o TOWN OF SOU~TTH.OlD ' (Building Inspector) APPLICATION FOR BUILDING PERMIT Date . /ybV ~S , , .. ., 19 INSTRUCTIONS a T}us application must be completely filled in by typewnter or m ink and submitted to the Building Inspector, wi sets of plans, accurate plot plan to scale Fee according to schedule b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public str or areas, and giving a detazled descnption of layout of property must be drawn on the diagram which is part of this at capon. c. The work covered by ttus apphcatton may not be commenced before issuance of Budding Permit d. Upon approval of this apphcatton, the Building Inspector will issued a Butldmg Pernut to the apphcant Such pe shall be kept on the premtses available for inspection throughout the work e. No building shall be occupied or used m whole or m part for any purpose whatever until a Certificate of Occup shall have been granted by the Bmldmg Inspector APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Bmldmg Permtt pursuant to Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other apphcable Laws, Ordinanc. Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein descnt The applicant agrees to comply with all apphcable laws, ordinances, building code, housing code, and regulations, an~ admit authonzed inspectors on premtses and in building for necessary inspections. (Sign ~ reKtf ali'phca , or ame, if a corporation) (Mailing address of applicant) State whether apphcant is owner, lessee, agent, architect, engineer, general contractor, electncian, plumber or buil~ Q 1 NN..C°_. (~. .. .... .. ... . .. .. .. .. .. . .. .. Name of owner of premises Cat i_~r~~l='9 ~ru~~=G,//~I (as on the tax roll or latest deed) if apphcant is a corporation, signature of duly authorized officer . . . . . .. . ... . . .. (Name and title of corporate officer) ALL CONTRACTOR'S MUST BE SUFFOLK COUNTY LICENSED Builder's License No. ...... . . Plumber's License No ~ `~~13,~ . . Electncian's License No .~ ~3 E .. Other Trade's License No. ~UQ 1 Location of land on which proposed work will be done !'~ ~=~ ~~~= ./.~ i~1 . . House Number Street Hamlet County Tax Map No 1000 Section ~ U `~ Block .. 3 .. ... Lot . .~ Subdivision Filed Map No .. Lot (Name) State existing use and occupancy of premises and intended use and occupancy of proposed construchan a. Existing use and occupancy b Intended use and occupancy ...ll!~G<t=. ~'°~%!4-~' ~-~Q/i'1 E' 3 Nature of work (check which appltcable) New Building ... .. Addition . V Alteration .. . .. .... Repair ... Removal . , ...... Demolftion ... .Other 1i'ork .. . . (DescnpYron) 4 Estimated Cost .. ~~Ss.~' ~ : ~ .. .. .. Fee . .. ..... . ` (to be patd on filing thfs apphcatron) 5 If dwelling, number of dwelling units . I. .. Number of dwelling units on each floor . . If garage, number of cazs .. .. ..... ... ....... _...~„ 6 If business, commercial or mixed occupancy, specrfy n ture and extent of each type of use .... . . 7. Drmensrons of existing structures, rf any Front ...'2.~~ ~ .~. ... Rear ... ~.f! ~ ~.' Depth . , ~/, 3, . d' ~, . Herg]rt ... .. Number of Stones . ~ ... .... Dunensronsarp~st~ture with alterations or additions Front .... .. Rear .. .. .. . . Depth .... . ~f1II'' . .. Height ... .. ..Number of Stones . / .. ... .... ... . 8 Drmensrp~rs of entire new construction Front .'~ ~. ~„ Rear .. :Z. b:.`'~. ~ .. Depth .. .3° 9,'.a' . , . Height ,~, ..'_ . .. .Number of Stones . ~-.. .. .. .. ..... .... . . .. p .. ........ .. 9. Srzf"tot Front .. Rear .. .. .. ... De th .. .. 10 Date of Purchase ..'71~'~... .. .. Name of Former Owner ..r~A!R1= V!-,+ANv. I 1 Zone or use district rn which premises are situated . .. .. ....... .. .. . . 12. Does proposed constructron violate any zoning law, ordinance or regulatron~ nl ~ ............... .. . . 13 Wrll lot be regraded . /~..1 ~ .. Will excess fill be removed from premises © 1` 14 Name of Owner of premises ..Address . . ... .. .. .Phone o .......... Name of Architect .. ... ..Address .... .Phone No. .... . . .. .. Name of Contractor . .... .. .. ... .... Address .... Phone No .... . I5. Is this property located within 300 feet of a tgqiudal wetland? *Yes ..... No ..... *If yes, Southold Town Trustees PermitPLO~ DIAGKAM ed. Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dunensions fro property hoes Gtve street and block number or descnptron according to deed, and show street names and indicate wheth rntenor or corner lot. 0 STATE OF NEW YORK, S S COUNTY OF .Ll-:-v~'$,.. ~jl(LGC~aa2y C~,u,Rrc=1 ~ .... being duly sworn, deposes and says that he is the apphca, (Name of individual signing contract) .rbove named He rs the (Contractor, agent, corporate officer, etc ) of said owner or owners, and rs duly authonzed to perform or have perfonned the said work and to make and file tt application, that all statements contained in this application are true to the best of his knowledge and belief, and that tl work will be perfonned m the manner set forth in the apphcatron 51ed therewith. Sworn to before me this MICHAEL L MORAIS .. 1.~. .day of ~c~ ........ , 19 . ~4. Notary Public, ..~c+~. ~ .~~i. C~+'.'t .. County Nofary Pi blic, State of New Yorh Na d14b20033 Qualified m Queens County Cert~f,'d m Nc,: Yorlc State 'Cc~mmfission Expires f"ECruary 29, 1990 ~~gnature of apphcar